File:Physical diagnosis (1912) (14772782942).jpg

Identifier: physicaldiagnosi12cabo (find matches)
Title: Physical diagnosis
Year: 1912 (1910s)
Authors: Cabot, Richard C. (Richard Clarke), 1868-1939
Subjects: Diagnosis Chest Diagnosis
Publisher: New York : William Wood and Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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iagnosis depends on microscopicexamination, animal inoculation, and the tuberculin test. (c) Syphilis; small, non-suppurating glands, occurring in the neckand about the occiput in adults, often accompany syphilis, but thediagnosis depends on the presence of unmistakable syphilitic lesionselsewhere. (d) Hodgkins disease; chronic, large, rarely suppurating glands inthe neck, axillae, and groins, with slight splenic enlargement and nor-mal blood, suggest Hodgkins disease, but microscopic examination is THE NECK 31 necessary to exclude tuberculosis. A superficial gland can be excisedunder cocaine, with very little pain. (e) Lymphatic Leukcemia. No distinguishing characteristics canbe found in the glands, but any nodular enlargement in the neckshould lead us to examine a film specimen of blood, and the leukaemicblood changes are easily and quickly recognized. (/) Malignant disease (near by or at a distance) may enlarge thecervical glands. Cancer of the lip or tongue, sarcoma of the tonsil,
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Fig. 27.—Hodgkins Disease, Six Months Duration. and, among distant lesions, cancer of the stomach and sarcoma of thelung have caused enlargement of these glands in cases under myobservation. (g) If the parotid gland alone is swollen and there are fever andpain on chewing, the case is probably one of mumps, especially ifthere are other cases in the vicinity. Malignant disease may alsoattack the parotid. (h) German measles may be accompanied by swelling of the pos-terior cervical or occipital glands without the involvement of anyother. 32 PHYSICAL DIAGNOSIS II. Abscess or Scars. Abscess or scars in the sides and front of the neck generally resultfrom glandular tuberculosis; hence the presence of scars may be ofvalue in the diagnosis of doubtful cases with a suspicion of tubercu-losis in later life. Aside from glandular abscesses (tuberculous orseptic) it is rare to find any suppuration in the neck, except in the nape,where deep, septic abscess (car-buncle) and superficial boils arecom

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